Something happening in Research in Canada …as you all know , I am not a low carber , living with D for close to 30 years . I like my " life style" and my aim is to continue for many years to come . 71 years young on July 25 !..I am involved with the CDA ( close to 28 years ) and a Regional Chair shared this website on our ( only for RC from across Canada ) FB group .
I wanted to share and hope those not touched by Diabetes as most of us are here will take note …
http://news.usask.ca/archived_ocn/11-mar-04/1.php
I find TuD almost liberal on the question of blood glucose control. When I first started participating on the T1 board at ADA, I remember having to defend myself for being satisfied with an A1c target of the very high 5s. There was also a woman who came once and innocently said that she had good control with an A1c of 6.7. She was told in no uncertain terms that she was practically inviting complications. Needless to say she never came back.
I absolutely agree that the bash fest on RDs and CDEs is deplorable. These people don’t go into healthcare to harm us and they actually have things to teach us if we are willing to learn. I like Alan’s formulation - his CDE is a misguided ally.
While low carbers sometimes annoy me and I’m sure I sometimes annoy low carbers the phrase “eat to meter” (modified by AcidRock’s “eat to pants”) forms a basis for us to get along. In a recent post, Kelly gave the advice that if the OP didn’t want to try low carb he should try to eat lower glycemic foods to limit his post prandial spikes. It was the opposite of low carb intolerance.
Maurie
I’m a T2 and that’s what happened to me - the diet they recommended would have put 25 pounds on my butt in a week. Luckily a podiatry nurse pulled me aside and told me about Dr. Bernstein early on.
And,perhaps the carb police? It is very difficult to discuss food without being sort of swamped with the suggestion that the only way to improve is to eat 30-? G of carbs / day. I think that a lot of stuff that is suggested is pretty correct but there’s a lot of active posters who are in the low-carb “gang” and not a lot of rebuttal from people who cough cough eat more and I’m a horrible example because I sort of kill myself so I can eat potato chips without throwing my BG out of whack.
In terms of this discussion, there is sort of an elitism here that seems like it might be offputting. I suppose that I am amongst the worst offenders with all of the exercising blah blah blah cakes. I dunno what else to say though.
I thinktoo that a lot of the “standards” emminate from administrators and risk managers who, of course, are all out playing golf with insurance companies. “how can we save $8 gazillion on test strips?” “raise the A1C target…nice shot!”
Lynne -
My first CDE at the Joslin told me not to correct if I was below 200. You can hear that either as anything under 200 is OK or you can hear that as - you haven’t nailed down your correction ratio and a unit of humalog might knock you down 100 points and you’ve already called me in a panic when you adjusted your insulin because you were a little high and ended up at 57. I was 3 weeks in at the time.
Gary Scheiner who has a deservedly good reputation wrote in an article in Diabetes Self Management a couple months back that an adult T1 should be under 170 two hours post. I doubt that he thinks that 170 is fine and dandy. That 170 is the border between being in the rough and flying off the course.
It’s possible to learn useful information from almost any CDE. Focusing on what they’re willing to give, allows us to manage the relationship and benefit from it…
Maurie
Couldn’t open the link Nel ;\
I clicked and it worked…HELP …what am I doing wrong ?
This is part of the " story "…I could copy and paste more ??? :
The work by Kaushik Desai and Lily Wu, professors in the Department of Pharmacology in the College of Medicine, focused on methylglyoxal (MG), which is produced naturally as the body metabolizes glucose consumed in carbohydrates. What they found was that high levels of MG produce all the features of type 2 diabetes, including damage to insulin producing cells in the pancreas, insulin resistance and impairment of body tissue to use glucose properly
The title is : Researchers link high-carbohydrate diet to disease
They can tell you anything they want to – they’re not in control of your diabetes. They aren’t sitting next to you deciding what you’re going to eat. So let them say it – it doesn’t make any difference, anyway! 
But of course, LCD is right – there are a lot of differences in the capacity of individual 70, 80, and 90 year-olds. We have a 92-year-old lady who folk dances with us. She doesn’t jump like the younger ones do, but she’s right there with the steps, and remembers more dances than any of the rest of us. She still drives her own car, and I went with her to a concert, and she is a good and careful driver. Yet there are many people younger than her who don’t have her physical abilities or mental sharpness. So that’s where the professional judgment comes in. And that shouldn’t be limited by some dumb study like the ACCORD. We aren’t study averages, we are individuals, and sometimes medical professionals seem to forget that!
I remember being on R and NPH, and I HAD to snack because of the peaks of the NPH. I couldn’t make it between breakfast and lunch without a low if I didn’t. And I had to have a bedtime snack, or I would go low in the middle of the night. And I HATED it. Most of the reason is that when I eat, I like to have a comfortably full stomach, but if I snacked, I had to cut back on my meals, so I was always hungry. That is NOT a way to live!
One of the reasons I love my pump with Novolog so much is that I can now eat when I’m hungry, be comfortable with the amount I eat, and lows are much rarer than they used to be. Of course, the reduced-carb is also helping – I can tell if I’m not getting enough protein, because I start craving carbs, and start getting insatiably hungry. But having figured out that protein will solve the problem, I’m sitting pretty!
I never get the impression that you look down on people that do not have the fortitude to exercise as intensly as you regularly do. Exercise has always been my weak point as far as DM management. Your posts actually motivate me to be better about it and I learn a good deal on how to better manage my BG’s while exercising from reading your posts.
As Dr. Richard Bernstein says it: “Diabetics are entitled to the same, normal blood sugars that non diabetics enjoy,”
Keep going with the exercise Acid! Just keep instructions and insulin around in case of pump failure.
I think you raise a very good point. (Oh, and BTW, I think you probably overlapped on the ADA T1 board with “Doris” !).
The point is, turning an online discussion forum into the place where the best controlled hang out as an elite club is exactly why I didn’t like some aspects of the OP’s post.
I don’t want to hang out here to listen to impossibly high standards and trite advice and the dietician-haters. I want to hang out here to hear about the real world as experienced by other PWD’s.
I sometimes get a little PO’d at the back flaps on Dr. Bernsteins books and some of the sound bites he puts out into the media regarding impossibly high standards, but “under the covers” he does have deep (not trite) advice. (Even his books of 20+ years ago had good advice… it would sound a little dated today!)
Well Tim, my latest A1C was 10.1…not exactly elite. Still, I am learning every day from these forums and hope to see a better result soon. Just had a test yesterday and, if it is better, I will attribute the improvement to these discussions on TuD. I’m feeling so much better.I’m so glad that everyone is proud of what they are doing because it has inspired me.
I find lots of positive comments here about RD’s/CDE Doctors etc.here. But it is hard to blame a T2 who decides to ignore the advice they have been given regarding targets and daily carb intake and then receives push back based on the ACCORD study, when they become cynical about professionals.
I think if your fellow professionals came here it would be useful to for them to hear both sides of the story, If your goal is to help people what good is it if your advice is ignored or worse you are discredited in their eyes because your advice was less than useful.
The goal should be not to become just as dogmatic about low carb as you were formerly about high carb, but instead to incorporate it into your tool kit and apply it as is appropriate. One can have strict targets and still not berate patients when they fall short. My own personal target is an A1C <5.5 the fact that I have never achieved it does not diminish it’s usefulness as a goal, in my view.
What he said
It’s working now – thanks, Nel!
I used to joke around that I was a 40 year old in a 90 year old body. When I did HBO in Pittsburgh, I lived in a senior apartment building owned by the hospital. A lot of those 90 year old women moved around a lot better than I did so I had to quit saying that! The HBO made me very tired in the beginning and I would go to bed very early. One of my first nights there, some of the women invited me to play Bingo after dinner – I was too tired to stay up and play Bingo with 80 and 90 year old women!